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Editor's Note
December 2018

The Persistent Problem of Overuse of Diagnostic Testing Among House Staff—Time to Move Forward

Author Affiliations
  • 1Department of Medicine, University of California, San Francisco
  • 2Editor, JAMA Internal Medicine
JAMA Intern Med. 2018;178(12):1721. doi:10.1001/jamainternmed.2018.3503

I was a second-year medical student at the University of Pennsylvania, Philadelphia, in 1978, and I had the immense good fortune to work with Sankey Williams, MD, and John Eisenberg, MD. They were performing a trial to evaluate the influence of education on reducing house staff use of unnecessary inpatient laboratory testing.1 The educational intervention had no benefit on house staff ordering behavior, but it had resounding effects on how I came to view routine use of many different types of testing and treatments that I had previously assumed were evidence based. That early research experience led me to carefully question the evidence base for many commonly used tests and procedures: How will the information from this test help me to take better care of my patient? Will it lead to better outcomes? Could I have gotten there without the use of this test?

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